Alimentäre Triggerfaktoren bei Migräne und Kopfschmerz vom Spannungstyp

Abstract

Based on a review of the literature the authors discuss the role of nutrition in the precipitation of migraine and tension-type headache (TTH). The available information relies largely on the subjective assessment of the patients. Controlled trials suggest that alcohol and caffeine withdrawal are the most important nutritional precipitating factors of migraine and TTH. In addition, there is some evidence that missing meals is also an important factor. Dehydration seems to deserve more attention. A selective sensitivity to red wine has been shown in some patients, the importance of chocolate has been doubted seriously, and scientific evidence for cheese as a precipitating factor is lacking. Despite a series of experimental studies demonstrating that NO donors such as nitroglycerin and parenteral histamine cause headache the role of histamine, nitrates, and nitrites in food remains unclear. Similarly, other biogenic amines and aspartame have not been proven to precipitate headache. Sodium glutamate causes adverse reactions including headache probably at large doses ingested on an empty stomach. Therefore, patients should be advised that food plays a limited role as a precipitating factor of migraine and TTH. Subjective sensitivity to certain foods should be examined critically, and proven precipitating factors should be avoided. General dietary restrictions have not been proven to be useful.

Trigger factors of migraine and tension-type headache: experience and knowledge of the patients

“…The level of knowledge about specific trigger factors differed most markedly in the "classical" nutritional triggers of migraine attacks, i.e., red wine, chocolate and cheese, which were best known in the MIG-C group. However, there is only evidence supporting the role of red wine, whereas chocolate and cheese have not been proven to trigger migraine attacks [22,23,26]. The marked discrepancy between personal experience and theoretical knowledge regarding the precipitation of migraine and TTH by chocolate and cheese indicates also that patient information -from whatever source ever [28] -overestimates these factors.…”

“…Numerous other trigger factors such as neck problems, exhaustion, sexual activity, posture, travelling, smoking, head trauma, fruits, vegetables, nuts, milk and dairy products have been suspected to provoke headache attacks, but scientific evidence is poor [26,27].…”

Association between lifestyle factors and headache

“…Behaviour-dependent so-called lifestyle factors have been of interest for the onset of migraine and frequent headaches for a long time. Certain trigger factors for migraine and for TTH have been identified in the past [4, 5]. These trigger factors include alcohol consumption and physical activity [6, 7].…”

Was sind echte Kopfschmerztrigger?

“…Wesentlich ist es jedoch, unter den zahllosen mit dem Auftreten von Kopfschmerzen in Zusammenhang gebrachten Faktoren jene zu identifizieren, für die es zumindest eine gewisse Evidenz aus wissenschaftlichen Studien gibt [2,3]. Die in der Literatur vorhandenen Daten beziehen sich zum Großteil auf Migräne und Kopfschmerz vom Spannungstyp (KST), und auch diese Übersicht beschäftigt sich mit diesen beiden Kopfschmerzformen.…”